Spinal fusion

Diskectomy in your neck (cervical spine) is most often done along with laminectomy, foraminotomy, or fusion.

Microdiskectomy is done in a hospital or outpatient surgical center. You will be given spinal anesthesia (to numb your spine area) or general anesthesia (asleep and pain-free).

The surgeon makes a small (1 to 1.5-inch or 2.5 to 3.8-centimeter) incision (cut) on your back and moves the back muscles away from your spine. The surgeon uses a special microscope to see the problem disk or disks and nerves during surgery.

The nerve root is located and gently moved away.

The surgeon removes the injured disk tissue and pieces of the disk.

The back muscles are returned to place.

The incision is closed with stitches or staples.

The surgery takes about 1 to 2 hours.

Diskectomy and laminotomy are usually done in the hospital, using general anesthesia (asleep and pain-free).

The surgeon makes a larger cut on your back over the spine.

Muscles and tissue are gently moved to expose your spine.

A small part of the lamina bone (part of the vertebrae that surrounds the spinal column and nerves) is cut away. The opening may be as large as the ligament that runs along your spine.

A small hole is cut in the disk that is causing your symptoms. Material from inside the disk is removed. Other fragments of the disk may also be removed.

Why the Procedure Is Performed

When one of your disks moves out of place (
herniates
), the soft gel inside pushes through the wall of the disk. The disk may then place pressure on the spinal cord and nerves that are coming out of your spinal column.

Herniates

A herniated (slipped) disk occurs when all or part of a disk is forced through a weakened part of the disk. This may place pressure on nearby nerves...

Many of the symptoms caused by a herniated disk get better or go away over time without surgery. Most people with low back or neck pain, numbness, or even mild weakness are often first treated with anti-inflammatory medicines, physical therapy, and exercise.

Only a few people with a herniated disk need surgery.

Your doctor may recommend a diskectomy if you have a herniated disk and:

Leg pain or numbness that is very bad or is not going away, making it hard to do daily tasks

Severe weakness in muscles of your lower leg or buttocks

Pain that spreads into your buttocks or legs

If you are having problems with your bowels or bladder, or the pain is so bad that strong pain drugs do not help, you will probably have surgery right away.

Risks

Risks for anesthesia and surgery in general are:

Reactions to medicines

Breathing problems

Bleeding, blood clots, infection

Risks for this surgery are:

Damage to the nerves that come out of the spine, causing weakness or pain that does not go away

Your back pain does not get better, or pain comes back later

Pain after surgery, if all the disk fragments are not removed

Spinal fluid may leak

The disk may bulge out again

Before the Procedure

Tell your doctor or nurse what medicines you are taking, even medicines, supplements or herbs you bought without a prescription.

During the days before the surgery:

Prepare your home for when you come back from the hospital.

If you are a smoker, you need to stop. Your recovery will be slower and possibly not as good if you continue to smoke. Ask your doctor for help.

Two weeks before surgery, you may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and other medicines like these.

If you have
diabetes
, heart disease, or other medical problems, your surgeon will ask you to see the doctors who treat you for those conditions.

Diabetes

Diabetes is a chronic disease in which the body cannot regulate the amount of sugar in the blood.

Care for yourself at home

Outlook (Prognosis)

Most people have pain relief and can move better after surgery. Numbness and tingling should get better or disappear. Your pain, numbness, or weakness may not get better or go away if you had nerve damage before surgery, or if you have symptoms caused by other spinal conditions.

Further changes may occur in your spine over time and new symptoms may occur.

Herniated nucleus pulposis - illustration

Herniated nucleus pulposus is a condition in which part or all of the soft, gelatinous central portion of an intervertebral disk is forced through a weakened part of the disk, resulting in back pain and nerve root irritation.

Herniated nucleus pulposis

illustration

Skeletal spine - illustration

The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.

Skeletal spine

illustration

Spine supporting structures - illustration

The spine is surrounded by many muscles and ligaments which give it great strength and flexibility. If these muscles or ligaments become damaged, back pain results.

Spine supporting structures

illustration

Cauda equina - illustration

The spinal cord ends in the lumbar area and continues through the vertebral canal as spinal nerves. Because of its resemblance to a horse's tail, the collection of these nerves at the end of the spinal cord is called the cauda equina. These nerves send and receive messages to and from the lower limbs and pelvic organs.

Cauda equina

illustration

Spinal stenosis - illustration

Spinal stenosis is a narrowing of the lumbar or cervical spinal canal. The narrowing can cause compression on nerve roots resulting in pain or weakness of the legs. Medications or steroid injections are often administered to reduce inflammation. If the pain is persistent and does not respond to these conservative measures, surgery is considered to relieve the pressure on the nerves.

Spinal stenosis

illustration

Microdiskectomy - series

Presentation

Herniated nucleus pulposis - illustration

Herniated nucleus pulposus is a condition in which part or all of the soft, gelatinous central portion of an intervertebral disk is forced through a weakened part of the disk, resulting in back pain and nerve root irritation.

Herniated nucleus pulposis

illustration

Skeletal spine - illustration

The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are the remaining vertebrae below the last thoracic bone and the top of the sacrum. The sacral vertebrae are caged within the bones of the pelvis, and the coccyx represents the terminal vertebrae or vestigial tail.

Skeletal spine

illustration

Spine supporting structures - illustration

The spine is surrounded by many muscles and ligaments which give it great strength and flexibility. If these muscles or ligaments become damaged, back pain results.

Spine supporting structures

illustration

Cauda equina - illustration

The spinal cord ends in the lumbar area and continues through the vertebral canal as spinal nerves. Because of its resemblance to a horse's tail, the collection of these nerves at the end of the spinal cord is called the cauda equina. These nerves send and receive messages to and from the lower limbs and pelvic organs.

Cauda equina

illustration

Spinal stenosis - illustration

Spinal stenosis is a narrowing of the lumbar or cervical spinal canal. The narrowing can cause compression on nerve roots resulting in pain or weakness of the legs. Medications or steroid injections are often administered to reduce inflammation. If the pain is persistent and does not respond to these conservative measures, surgery is considered to relieve the pressure on the nerves.